New Bedside Screening Effectively Identifies Patients

The U-M is the coordinating center for the largest-ever study of aortic dissection patients and the study results were compiled from the International Registry of Acute Aortic Dissection. The study shows that with the help of an aortic dissection detection risk score, generated by a simple, bedside screening tool, doctors can usually identify signs or symptoms of acute aortic dissection, which include abrupt, intense pain. "The results from this study suggest that the risk score, with the use of only information that is available at the bedside, can identify the vast majority of patients presenting with acute aortic dissection," says study senior author and cardiologist Doctor Kim A. Eagle, a director of the U-M Cardiovascular Center.

Nearly 10.000 Americans suffer aortic dissections each year, and nearly one in three dies before leaving the hospital despite recent advances in diagnostic tools and surgical treatment. Of the 2.538 IRAD patients examined, 95 percent had one or more of the 12 proposed clinical risk markers and 86 percent had at least two of the risk markers. Patients with acute aortic dissection frequently had an abrupt onset of pain, severe intensity of pain and pain described as ripping or tearing, according to the study. The ADD risk score was created from these guidelines to provide doctors with a fast, simple and systematic method for screening large volumes of patients at the bedside. "Because of its symptoms, aortic dissection is often mistaken for other cardiovascular conditions," says study co-author Doctor Adam M. Rogers, also of U-M.

Without emergency attention and treatment — and even, often with it — the torn lining can continue to rip, block blood flow to key arteries in the body, cause the heart to fail, or make the aorta swell into an aneurysm or rupture entirely. Also at risk are people with other heart valve and aorta problems, high blood pressure, or a family history of aortic dissections. Some people with aortic dissection can achieve a stable state with their condition, at least for a while, but most cases are acute and must be treated quickly. Aortic dissection lead to the sudden death of award-winning TV actor John Ritter in 2003, and brought the world's attention to a heart condition that few survive.